Article type
Year
Abstract
Background and objective: The aim of this research was to design and to
validate a scale to detect major depressive disorders in elderly people consulting in primary care and in whom an alteration is suspected in their affective state (Detection of Depression in Elderly Scale -EDDA-). Patients and method: Observational and cross-sectional study for the validation of a scale, administered by means of a personal interview, in 259 patients 65 years old or older. After the revision of available instruments and elaboration of the questions, a first pilot study was carried out. In a second pilot study the reproductibility of the instrument was analyzed. The gold standard was the result of a standardized psychiatric interview performed by psychiatrists (DSM-IV criteria and SCAN interviews).
Results: The intraclass correlation coefficient corresponding to the test-retest and inter-raters reliability were, respectively, 0,858 (CI 95%: 0,634 - 0,946) and 0,908 (CI 95%: 0,726 - 0,969). 216 subjects underwent the assessment, in which a valuation in consultations of primary attention and of psychiatry was carried out in a blind way. The psychiatrists diagnosed major depression in 81 cases (37,5%; CI 95%: 31,1 - 44,4). The EDDA showed good internal consistency (Cronbach s alpha = 0,79). The exploratory factorial analysis revealed a 8-component structure (55,8% of explained variance). A cutoff score of 14/15 for the EDDA had a sensitivity of 90,1% (CI: 80,95-95,33) and a specificity of 74,8% (CI: 66,48-81,71). Conclusions: The EDDA constitutes an clinically useful instrument for the detection of the major depression in the elderly in primary care, where normally they can be ignored. The scale presents some good psychometric properties and, by means of factorial analysis, the EDDA has demonstrated their multiple dimensions and good internal consistency. The test-retest and inter-raters reliability showed elevated intraclass correlation coefficient.
validate a scale to detect major depressive disorders in elderly people consulting in primary care and in whom an alteration is suspected in their affective state (Detection of Depression in Elderly Scale -EDDA-). Patients and method: Observational and cross-sectional study for the validation of a scale, administered by means of a personal interview, in 259 patients 65 years old or older. After the revision of available instruments and elaboration of the questions, a first pilot study was carried out. In a second pilot study the reproductibility of the instrument was analyzed. The gold standard was the result of a standardized psychiatric interview performed by psychiatrists (DSM-IV criteria and SCAN interviews).
Results: The intraclass correlation coefficient corresponding to the test-retest and inter-raters reliability were, respectively, 0,858 (CI 95%: 0,634 - 0,946) and 0,908 (CI 95%: 0,726 - 0,969). 216 subjects underwent the assessment, in which a valuation in consultations of primary attention and of psychiatry was carried out in a blind way. The psychiatrists diagnosed major depression in 81 cases (37,5%; CI 95%: 31,1 - 44,4). The EDDA showed good internal consistency (Cronbach s alpha = 0,79). The exploratory factorial analysis revealed a 8-component structure (55,8% of explained variance). A cutoff score of 14/15 for the EDDA had a sensitivity of 90,1% (CI: 80,95-95,33) and a specificity of 74,8% (CI: 66,48-81,71). Conclusions: The EDDA constitutes an clinically useful instrument for the detection of the major depression in the elderly in primary care, where normally they can be ignored. The scale presents some good psychometric properties and, by means of factorial analysis, the EDDA has demonstrated their multiple dimensions and good internal consistency. The test-retest and inter-raters reliability showed elevated intraclass correlation coefficient.